NPIMap

Organization Active NPI

Legend Treatment Center of Cleveland, LLC

  • Substance Abuse Rehabilitation Facility
  • Cleveland, OH
National Provider Identifier
1720714561
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
LEGEND TREATMENT CENTER OF CLEVELAND, LLC
Practice address
14445 Broadway Ave
Cleveland, OH 44125-1957
Phone
(844) 534-3638
NPI assigned
Jul 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eva I Dudek, B.S., MHA, CAP
Title
Chief Compliance/Project Officer
Phone
(561) 301-9423

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

14445 Broadway Ave
Cleveland, OH 44125-1957

Mailing address

95 Main Ave Ste 121
Clifton, NJ 07014-1757
Phone (844) 534-3638

National Provider Directory

National Provider Directory
Tax ID family
Legend Treatment Center of Cleveland LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14445 Broadway Ave
Cleveland, OH 44125
Phone (216) 450-6799

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1720714561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 MAIN AVE STE 121",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070141757",
            "telephone_number": "844-534-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441251957",
            "telephone_number": "844-534-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGEND TREATMENT CENTER OF CLEVELAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "DUDEK",
        "authorized_official_first_name": "EVA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE/PROJECT OFFICER",
        "authorized_official_telephone_number": "561-301-9423",
        "authorized_official_credential": "B.S., MHA, CAP"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.